ORİJİNAL ARAŞTIRMALAR
Kliniğimizde Yapılan Laparoskopik ve Laparotomik Myomektomilerin Değerlendirilmesi
Evaluation of Laparoscopic and Laparotomic Myomectomies in Our Clinic
Received Date : 09 Dec 2020
Accepted Date : 26 Jan 2021
Available Online : 03 Feb 2021
Şükriye Leyla ALTUNTAŞa, Suna KABİL KUCURa, Adeviye Elçi ATILGANa, Sema OVALIa,
Gürkan ZORLUa
aKoşuyolu İstanbul Medipol Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, İstanbul, TÜRKİYE
Doi: 10.24074/tjrms.2020-80467 - Makale Dili: TR
TJRMS. 2020;4(1):24-8
ÖZET
Amaç: Çalışmamızın amacı kliniğimizde laparoskopik ve laparotomik yöntemle myomektomi yaptığımız toplam 102 hastanın sonuçlarını retrospektif
olarak literatür eşliğinde incelemektir. Gereç ve Yöntemler: Koşuyolu Medipol Hastanesi Kadın Hastalıkları ve Doğum Kliniği’nde
Ocak 2013-Ocak 2019 tarihleri arasında laparoskopik myomektomi yapılan 56 hasta ve laparotomik myomektomi yapılan 46 hasta ameliyat endikasyonları,
komplikasyonlar, preoperatif ve postoperatif hemoglobin değerleri, transfüzyon ihtiyacı, ameliyat süresi ve hastanede kalış süresi
açısından retrospektif olarak değerlendirildi. Bulgular: Laparoskopik ve laparotomik myomektomi yapılan hastaların yaş ortalaması sırasıyla
36.85 ± 6.39 ve 38.91 ± 5.29 idi (p: 0.08). Operasyon süresi sırasıyla 108.68 ± 42.67 ve 84.4 ± 26.6 dakikaydı (p:0.003). Hastanede yatış süresi
laparoskopik myomektomi grubunda anlamlı olarak düşüktü (p<0.05). Preoperatif hemoglobin değerleri gruplar arası benzer iken, postoperatif
hemoglobin değerleri laparoskopik ve laparotomik myomektomi yapılan hastalarda sırasıyla 10.5 ± 1.51 ve 9.7 ±1.14 olduğu gözlendi (p: 0.03).
Trasfüzyon ihtiyacı gruplar arası benzerdi (p: 0.28). Sonuç: Laparoskopik miyomektomi birçok açıdan laparotomik miyomektomiye tercih edilebilecek
bir yöntemdir. Daha erken taburcu olma ve rutin hayatına erken dönme gibi üstünlükleri vardır. Laparoskopi cerrahi ekipman çeşitlerinin
artması, animasyon, kadavra ve video eğitim imkanlarının yaygınlaşması sayesinde gün geçtikçe artan sıklıkla yapılacak cerrahilerdendir.
Pratik uygulamaların sıklaşması ve yetkin bireylerden kurulu cerrahi ekiplerin elinde, şimdilik handikap gibi görülen uzun ameliyat sürelerinin
de kısalacağını düşünmekteyiz.
Anahtar Kelimeler: Myomektomi; laparoskopi; laparoskopik myomektomi
ABSTRACT
Objective: The aim of this study is to evaluate the results of laparoscopic and abdominal myomectomy procedures with respect to preoperative
and postoperative hemoglobin/hematocrite values, operation time, size of leimyomas, transfusion need, hospital stay time and complications.
Material and Methods: In this study, we retrospectively evaluated 102 cases who were performed myomectomy operation at Obstetrics and Gynecology
Clinic of Istanbul Koşuyolu Medipol Hospital between 2013-2019. All cases were divided into two groups with respect to the surgical
procedure performed. 46 patients were in the abdominal myomectomy group, 55 patients were in the laparoscopic myomectomy group and the
both groups were compared. Results: There is no significant difference in age, postoperative need for transfusion between the groups. The mean
number of parity was higher in the laparoscopic myomectomy group. In abdominal myomectomy group, number of cases, in which myoma was
greater than 5cm in diameter, were almost equal to laparoscopic myomectomy group, however mean size of leimyomas of laparotomies 83mm
was greater than the mean size of leimyomas of laparoscopies 61mm. The duration of hospital stay was longer (p <0.05), and operation time was
shorter ( p:0,003) and while postoperative hemoglobin levels were lower in laparotomic myomectomy group when compared with laparoscopic
myomectomy group (p:0.03). Conclusion: The laparoscopy was more advantageous than abdominal surgery with hospital stay time, postoperative
hemoglobin levels.
Keywords: Myomectomy; laparoscopy; laparoscopic myomectomy
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